Background
Methods
Ethics statement
Statistical analysis
Results
Impact of SLNM on CC survival outcomes
Total | N0 | N1a | N1b | P value | |
---|---|---|---|---|---|
Characteristic | (n = 86674) | (n = 61696) | (n = 12416) | (n = 12562) | |
Media follow up (mo) | 85 | 90 | 78 | 69 | <0.001 |
(IQR) | (54–121) | (62–124) | (39–116) | (30–108) | |
Years of diagnosis | 0.102 | ||||
1988-1993 | 17214 | 12196 | 2489 | 2529 | |
1994-1999 | 24641 | 17436 | 3629 | 3576 | |
2000-2003 | 32064 | 17436 | 6298 | 6457 | |
Sex | 0.818 | ||||
Male | 43210 | 30798 | 6177 | 6235 | |
Female | 43464 | 30898 | 6239 | 39876327 | |
Age | <0.001 | ||||
<60 | 27442 | 18170 | 4293 | 4439 | |
≥60 | 59232 | 42986 | 8123 | 8123 | |
Race | <0.001 | ||||
White | 69850 | 50278 | 9667 | 9905 | |
Black | 9407 | 6337 | 1574 | 1496 | |
Other | 7154 | 4872 | 1145 | 1137 | |
Unknown | 263 | 209 | 30 | 24 | |
Pathological grading | <0.001 | ||||
High/moderate | 41097 | 28840 | 6121 | 6136 | |
Poor/anaplastic | 7723 | 4503 | 1434 | 1786 | |
Unknown | 1750 | 1232 | 251 | 267 | |
Histotype | <0.001 | ||||
Adenocarcinoma | 76387 | 54697 | 10817 | 10873 | |
Mucinous cell | 9667 | 6671 | 1480 | 1516 | |
Signet ring cell | 486 | 239 | 96 | 151 | |
T stage | <0.001 | ||||
T1 | 12141 | 11055 | 746 | 340 | |
T2 | 14570 | 11995 | 1531 | 1044 | |
T3 | 28192 | 18982 | 4532 | 4678 | |
T4a | 27669 | 17195 | 4860 | 5614 | |
T4b | 4102 | 2469 | 747 | 886 | |
No. of LNs dissected | <0.001 | ||||
<12 | 47920 | 34671 | 6693 | 6556 | |
≥12 | 38754 | 27025 | 5723 | 6006 |
Univariate analysis | Multivariate analysis | ||||
---|---|---|---|---|---|
Variable | 5-year CCS | Log rank χ
2test | P | HR (95% CI) | P |
Years of diagnosis | 15.944 | <0.001 | <0.001 | ||
1988-1993 | 94.9% | Reference | |||
1994-1999 | 95.6% | 0.815 (0.784-0.848) | |||
2000-2003 | 96.6% | 0.692 (0.667-0.718) | |||
Sex | 0.706 | 0.401 | NI | ||
Male | 96.0% | ||||
Female | 96.2% | ||||
Age | 45.295 | <0.001 | <0.001 | ||
<60 | 97.6% | Reference | |||
≥60 | 95.3% | 1.467 (1.419-1.516) | |||
Race | 16.447 | <0.001 | <0.001 | ||
White | 96.3% | Reference | |||
Black | 93.4% | 1.428 (1.152-1.770) | |||
Othera
| 97.6% | 0.718 (0.528-0.976) | |||
Grade | 19.124 | <0.001 | <0.001 | ||
High/moderate | 96.2% | Reference | |||
Poor/anaplastic | 93.1% | 1.281 (1.234-1.330) | |||
Unknown | 96.8% | 0.871 (0.802-0.946) | |||
Histotype | 0.923 | 0.337 | NI | ||
Adenocarcinoma | 96.1% | ||||
Mucinous/signet ring cell | 96.8% | ||||
No. of LNs dissected | 0.413 | 0.520 | NI | ||
<12 | 95.9% | ||||
≥12 | 96.5% | ||||
LNs status | 221.646 | <0.001 | <0.001 | ||
N0 (pI) | 96.7% | 0.456 (0.439-0.473) | |||
N1a | 92.6% | Reference | |||
N1b | 83.2% | 1.424 (1.365-1.486) |
Univariate analysis | Multivariate analysis | ||||
---|---|---|---|---|---|
Variable | 5-year CCS | Log rank χ
2test | P | HR (95% CI) | P |
Years of diagnosis | 30.763 | <0.001 | <0.001 | ||
1988-1993 | 90.9% | Reference | |||
1994-1999 | 92.0% | 0.903 (0.789-1.033) | |||
2000-2003 | 93.6% | 0.727 (0.637-0.830) | |||
Sex | 27.577 | <0.001 | <0.001 | ||
Male | 91.8% | Reference | |||
Female | 93.5% | 0.734 (0.664-0.812) | |||
Age | 77.274 | <0.001 | <0.001 | ||
<60 | 95.4% | Reference | |||
≥60 | 91.5% | 1.823 (1.612-2.061) | |||
Race | 35.396 | <0.001 | <0.001 | ||
White | 92.8% | Reference | |||
Black | 89.6% | 1.517 (1.306-1.762) | |||
Othera
| 94.9% | 0.692 (0.558-0.858) | |||
Grade | 4.629 | 0.099 | NI | ||
High/moderate | 92.9% | ||||
Poor/anaplastic | 90.9% | ||||
Unknown | 91.4% | ||||
Histotype | 0.190 | 0.663 | NI | ||
Adenocarcinoma | 92.9% | ||||
Mucinous/signet ring cell | 92.5% | ||||
No. of LNs dissected | 20.732 | <0.001 | <0.001 | ||
<12 | 91.7% | Reference | |||
≥12 | 94.0% | 0.846 (0.761-0.941) | |||
LNs status | 223.132 | <0.001 | 0.002 | ||
N0 | 94.2% | 0.485 (0.423-0.556) | |||
N1a | 87.2% | Reference | |||
N1b | 83.8% | 1.270 (1.060-1.521) |
Univariate analysis | Multivariate analysis | ||||
---|---|---|---|---|---|
Variable | 5-year CCS | Log rank χ
2test | P | HR (95% CI) | P |
Years of diagnosis | 39.995 | <0.001 | <0.001 | ||
1988-1993 | 80.3% | Reference | |||
1994-1999 | 82.6% | 0.874 (0.808-0.946) | |||
2000-2003 | 84.6% | 0.820 (0.763-0.881) | |||
Sex | 25.387 | <0.001 | <0.001 | ||
Male | 82.7% | Reference | |||
Female | 84.3% | 0.855 (0.811-0.901) | |||
Age | 169.293 | <0.001 | <0.001 | ||
<60 | 87.3% | Reference | |||
≥60 | 81.7% | 1.542 (1.453-1.638) | |||
Race | 103.809 | <0.001 | <0.001 | ||
White | 84.1% | Reference | |||
Black | 77.7% | 1.461 (1.355-1.574) | |||
Othera
| 86.2% | 0.801 (0.733-0.896) | |||
Grade | 15.823 | <0.001 | 0.032 | ||
High/moderate | 84.0% | Reference | |||
Poor/anaplastic | 80.8% | 1.098 (1.024-1.178) | |||
Unknown | 83.5% | 1.003 (0.851-1.182) | |||
Histotype | 1.212 | 0.271 | NI | ||
Adenocarcinoma | 83.5% | ||||
Mucinous/signet ring cell | 83.8% | ||||
No. of LNs dissected | 270.983 | <0.001 | <0.001 | ||
<12 | 80.0% | Reference | |||
≥12 | 86.8% | 0.668 (0.633-0.705) | |||
LNs status | 1209.713 | <0.001 | <0.001 | ||
N0 (pIIA) | 88.4% | 0.510 (0.476-0.546) | |||
N1a | 77.8% | Reference | |||
N1b | 69.4% | 1.449 (1.334-1.561) |
Univariate analysis | Multivariate analysis | ||||
---|---|---|---|---|---|
Variable | 5-year CCS | Log rank χ
2test | P | HR (95% CI) | P |
Years of diagnosis | 61.405 | <0.001 | <0.001 | ||
1988-1993 | 72.8% | Reference | |||
1994-1999 | 77.1% | 0.836 (0.792-0.883) | |||
2000-2003 | 77.8% | 0.848 (0.803-0.896) | |||
Sex | 35.224 | <0.001 | <0.001 | ||
Male | 75.1% | Reference | |||
Female | 77.2% | 0.859 (0.822-0.898) | |||
Age | 136.610 | <0.001 | <0.001 | ||
<60 | 79.9% | Reference | |||
≥60 | 74.5% | 1.383 (1.316-1.454) | |||
Race | 85.397 | <0.001 | <0.001 | ||
White | 76.7% | Reference | |||
Black | 69.1% | 1.357 (1.270-1.450) | |||
Othera
| 79.7% | 0.845 (0.777-0.918) | |||
Grade | 52.978 | <0.001 | 0.032 | ||
High/moderate | 77.3% | Reference | |||
Poor/anaplastic | 71.5% | 1.178 (1.116-1.244) | |||
Unknown | 75.5% | 1.053 (0.917-1.210) | |||
Histotype | 0.011 | 0.915 | NI | ||
Adenocarcinoma | 76.2% | ||||
Mucinous/signet ring cell | 76.0% | ||||
No. of LNs dissected | 266.370 | <0.001 | <0.001 | ||
<12 | 72.4% | Reference | |||
≥12 | 80.4% | 0.708 (0.676-0.740) | |||
LNs status | 1213.378 | <0.001 | <0.001 | ||
N0 (pIIB) | 82.7% | 0.559 (0.528-0.592) | |||
N1a | 69.9% | Reference | |||
N1b | 61.7% | 1.317 (1.239-1.401) |
Univariate analysis | Multivariate analysis | ||||
---|---|---|---|---|---|
Variable | 5-year CCS | Log rank χ
2test | P | HR (95% CI) | P |
Years of diagnosis | 37.575 | <0.001 | 0.001 | ||
1988-1993 | 44.4% | Reference | |||
1994-1999 | 49.2% | 0.905 (0.807-1.014) | |||
2000-2003 | 55.7% | 0.809 (0.726-0.902) | |||
Sex | 1.163 | 0.281 | NI | ||
Male | 51.9% | ||||
Female | 50.7% | ||||
Age | 41.821 | <0.001 | <0.001 | ||
<60 | 56.7% | Reference | |||
≥60 | 48.0% | 1.329 (1.213-1.456) | |||
Race | 19.460 | <0.001 | <0.001 | ||
White | 52.0% | Reference | |||
Black | 42.3% | 1.337 (1.175-1.522) | |||
Othera
| 56.4% | 0.920 (0.781-1.084) | |||
Grade | 48.208 | <0.001 | <0.001 | ||
High/moderate | 54.3% | Reference | |||
Poor/anaplastic | 44.8% | 1.343 (1.219-1.479) | |||
Unknown | 41.7% | 1.324 (1.094-1.601) | |||
Histotype | 0.024 | 0.877 | NI | ||
Adenocarcinoma | 51.2% | ||||
Mucinous/signet ring cell | 51.4% | ||||
No. of LNs dissected | 158.496 | <0.001 | <0.001 | ||
<12 | 42.4% | Reference | |||
≥12 | 60.4% | 0.598 (0.548-0.653) | |||
LNs status | 1213.378 | <0.001 | <0.001 | ||
N0 (pIIC) | 60.6% | 0.596 (0.534-0.666) | |||
N1a | 40.5% | Reference | |||
N1b | 34.1% | 1.201 (1.062-1.358) |
Comparison of CCSS between patients with pT1-4aN1a and those with pII stage CC
Variable | HR (95% CI) | P | HR (95% CI) | P | HR (95% CI) | |
---|---|---|---|---|---|---|
pTNM stage | <0.001 | <0.001 | <0.001 | |||
IIA | Reference | 0.723 (0.688-0.759) | <0.001 | 0.271 (0.252-0.290) | <0.001 | |
IIB | 1.384 (1.317-1.453) | <0.001 | Reference | 0.374 (0.350-0.401) | <0.001 | |
IIC | 3.695 (3.443-3.966) | <0.001 | 2.671 (2.495-2.859) | <0.001 | Reference | |
T1-2N1a | 0.937 (0.838-1.049) | 0.259 | 0.677 (0.606-0.757) | <0.001 | 0.254 (0.224-0.287) | <0.001 |
T3-4aN1a | 2.221 (2.109-2.339) | <0.001 | 1.605 (1.529-1.685) | <0.001 | 0.601 (0.560-0.645) | <0.001 |
T4bN1a | 6.506 (5.886-7.192) | <0.001 | 4.703 (4.262-5.189) | <0.001 | 1.761 (1.576-1.966) | <0.001 |
T1-2N1b | 1.344 (1.189-1.518) | <0.001 | 0.971 (0.861-1.096) | 0.634 | 0.364 (0.319-0.414) | <0.001 |
T3-4aN1b | 3.060 (2.915-3.211) | <0.001 | 2.212 (2.115-2.312) | <0.001 | 0.828 (0.774-0.886) | <0.001 |
T4bN1b | 8.011 (7.328-8.757) | <0.001 | 5.790 (5.307-6.317) | <0.001 | 2.168 (1.961-2.397) | <0.001 |